Current through all regulations passed and filed through September 16, 2024
(A)
For the purpose
of this rule:
(1)
"Age and service retirant" shall mean a former member
that applied for and was granted retirement benefits as described in section
5505.16 of the Revised
Code.
(2)
"Benefit recipient" shall mean an age and service
retirant or disability retirant that is receiving a pension benefit as
described in division (A)(1) of section
5505.17 of the Revised Code that
qualifies for health care coverage pursuant to paragraph (D) of this rule.
Benefit recipient does not include a member participating in the "Deferred
Retirement Option Plan."
(3)
"Dependent" shall mean a spouse as defined in this
rule.
(4)
"Disability retirant" shall mean a former member that
applied for and was granted retirement benefits as described in section
5505.18 of the Revised
Code.
(5)
"Eligible dependent" shall mean a dependent that
qualifies for health care coverage pursuant to paragraph (F) of this
rule.
(6)
"Health care service credit" shall include:
(a)
Credit earned as
an employee as defined by division (A) of section
5505.01 of the Revised
Code;
(b)
Military service credit purchased pursuant to division
(D) of section 5505.16 of the Revised
Code;
(c)
Credit granted under section
5505.201 of the Revised Code;
and
(d)
Years of participation in the deferred retirement
option plan pursuant to section
5505.51 of the Revised
Code.
(7)
"Health reimbursement arrangement plan" or "HRA" shall
mean the HPRS amended and restated health reimbursement arrangement plan,
effective November 1, 2023, from which the reimbursement of qualifying medical
expenses may be made. The HRA may have component plans as determined by the
HPRS board. The text of the HPRS health reimbursement arrangement plan shall
not be incorporated into this or any other rule of the Administrative
Code.
(8)
"Member" shall have the same meaning as division (I) of
section 5505.01 of the Revised
Code.
(9)
"Monthly health care allowance" or "monthly allowance"
shall mean the monthly amount that is allocated to each individual enrolled in
the health reimbursement arrangement plan. The monthly allowance shall be
determined by the board and offered in the form of a notional credit to the
health reimbursement arrangement consistent with the provisions of the
plan.
(10)
"Retirant" shall mean an age and service retirant or
disability retirant.
(11)
"Spouse" shall mean a wife or husband of a retirant or
member as set forth in a statutorily-valid certificate.
(B)
Except
as provided in this rule, the rights of an individual participating in the
health reimbursement arrangement plan to a monthly allowance or to
reimbursement, including eligibility and coordination of coverage, shall be
governed exclusively by the provisions of the HPRS health reimbursement
arrangement plan.
(1)
All provisions of this rule are subject to current
health care contracts and amendments.
(2)
The board may
implement cost control measures as it deems necessary.
(C)
Notwithstanding any other provision of this rule, any
benefit recipient or eligible dependent that is or becomes employed by the
state highway patrol in any capacity shall be ineligible for health care or
prescription coverage.
(D)
The following benefit recipients shall be eligible for
health care:
(1)
Except as provided in paragraph (D)(3) of this rule, a
benefit recipient that began receiving a pension pursuant to division (A)(1) of
section 5505.17 of the Revised Code, or
deferred retirement under section
5505.16 of the Revised Code, or
elected to participate in the deferred retirement option plan pursuant to
section 5505.51 of the Revised Code
before November 1, 2023;
(2)
Except as provided in paragraph (D)(3) of this rule, a
benefit recipient that began receiving a pension pursuant to division (A)(1) of
section 5505.17 of the Revised Code or
elected to participate in the deferred retirement option plan pursuant to
section 5505.51 of the Revised Code on
or after November 1, 2023 shall be eligible for health care coverage only if he
or she has twenty or more years of health care service credit;
(3)
A benefit
recipient granted a disability pursuant to section
5505.18 of the Revised
Code.
(E)
The board may require documented proof of marriage,
guardianship, or parenthood. The board reserves the right to deny or cancel
coverage if the benefit recipient or dependent does not comply with the board's
request for documents.
(F)
After the death of a retirant or member, dependents may
become eligible for health care coverage, subject to the following
conditions:
(1)
(a)
If the retirant
or member was or was eligible to be a benefit recipient, and was eligible for
health care coverage under paragraph (D) of this rule, at the time of death;
or
(b)
If the retirant or member was not eligible to be a
benefit recipient at the time of death, the dependent becomes eligible the date
on which the member would have been eligible to enroll pursuant to paragraph
(D) of this rule.
(G)
An individual who
receives benefits in accordance with section
5505.16,
5505.17, or
5505.18 of the Revised Code may
be reimbursed for medicare part B premiums upon the receipt of evidence of
coverage, up to a maximum amount established by the board.
The reimbursement amount for calendar year 2017 and
each year thereafter shall be zero.
(H)
Any person
eligible to receive a monthly allowance or reimbursement under the health
reimbursement arrangement plan shall inform the retirement system, in writing,
not later than thirty days after the person no longer meets the requirements of
the health reimbursement arrangement plan.
Replaces: 5505-7-04
